NPI | 1225516933 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: IL 1225516933) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 1225516933) |
Enumeration Date | 2018-08-03 |
Last Update Date | 2025-06-09 |